Pneumonia (bacterial)
Acute inflammation of lung
Pneumonia Pathophysiology
Inflammatory and immune respones, resulting in edema. Impairs gas exchange
Risk factors of Pneumonia
Existing disease, Smoking, Alcohol, Hospitalized patients, Chemicals and pollutants, surgery or trauma
Etiology (cause) of Pneumonia
Anyone--Debilitated, post op patients, respiratory disease, weakended immune systems.
Symptoms of pneumonia
Chills, high fever, chest pain, cough and mucus
Most common infectious organism
Streptococcus pneumonia---is part of the normal upper respiratory tract flora but as with many natural flora, it can become pathogenic under the right conditions
Viral Pneumonia Symptoms
Fever, dry cough, headache, muscle pain and weakness
Viral Pneumonia
Milder than bacterial pneumonia
Mycoplasma Pneumonia
frequently in older children and young adults, low mortality.
Mycoplasma Symptoms
whitish mucus, chills and fever, weakness
Pneumocystic Carinii Symptoms
Cough, Fever, Tachpnea, Dyspnea Most commonly found in the lungs of healthy people but can cause lung infection in people with weak immune system.
Pneumocystic Carinii
caused by the yeast-like fungus
Aspiration
the release of a strong burst of air after some obstuents
Aspiration pneumonia
Inhalation of foreign material. Develops due to the entrance of foreign materials that enter the bronchial tree.
Nursing Diagnoses for pneumonia
Impaired gas exchange, Activity Intolerance, Hyperthemia, Imbalanced nutrition r/t dyspnea, Anxiety r/t shortness of air, Pain r/t frequent coughing
Planning and Implementation
Maintain patent airway (keep head up, DB&C, Assess color and characteristics secreations & amount, Monitor respiratiory and oxygenation status (rate, rhythm), Provide nutritional support and fluids, and oportunites for rest.
Preventing pneumonia w/ hospitalized pt's
Identify clients at high risk, Maintain appropriate infection control measures, Maintain adequate nutrition, Encourage activity and mobility as soon as feasible.
Medication Therapy
Antibiotics (first thing used), Analgesics, Antipyretics
Macrolides
Azithromycin, erythromycin
2nd Generation Cephlasporins
cefuroxime
Fluoroquinolones
Lefofloxacin
Education Pt's about pneumonia
Get immunizations, Activity level, advise them to report symptoms to health care provider.
Expected Outcomes/Evaluation
Clear breath sounds, Effective coughing, Decreased or absent pain, Afebril, No Activity intolerance
What is the most common pathogen causing pneumonia?
Streptococcus pneumonia
Which symptoms are most commonly presented in the elderly person with pneumonia?
Fever, Tachypnea, Altered Mentation or agitation.
What symptoms would lead the nurse to believe it is appropriate to discharge the patient with pneumonia?
Clear breath sounds, Effective coughing, Decrease of pain
Pneumonia often follows
Influenza
How is pneumonia detected?
Chest x-ray (3 sides) provides information about the location and a Definitive diagnosis is determined through sputum culture used for ICU pt's.
Cough Reflex
A client asks the nurse what keeps food from reaching the lungs....Which reflex?
Sitting
During assessment of the respiratory system, the client should be placed in which position?
Altered mental status and dehydration
An elderly client with pneumonia may appear with which of the following symptoms first?
Inflammation
What pathophysiological mechanism occurs in the lung parenchyma and allows pneumonia to develop?
Group Living
Patients with chronic illnesses are more likely to get pneumonia when what is present?
Community Acquired Pneumonia
Acquired outside of the hospital---Most common is streptoccol
Important to do while pt is in hospital.
Turn, cough, deep breath
Elderly / Older client with Pneumonia.
Symptoms are more vague, minimal or no cough, with very little sputum.
Implementing
Provide supplemental oxygen, administer medications, Pain management (NSAIDS) Narcotics decrease respirations so should try to avoid. Provide Nutional support and opportunity for rest.
What is the Primary Transmission of Pneumonia? Secondary?
Primary: Droplets of Respiratory Secretions that are Airborne by a direct person to person interaction from a Sick Person or Asymptomatic Carrier; Secondary: Carried on Hands contaminated w/ the secretions
Hospital Aquired Pneumonia----(HAP)
occurs 48 hours or longer after hospital admission VAP- occurs more than 48 or 72 hours after intubation. The microorganism responsible for HAP is usually bacterial and rarely viral or fungal